Clinical Trial Service Unit

About: Clinical Trial Service Unit is a based out in . It is known for research contribution in the topics: Population & Stroke. The organization has 428 authors who have published 1387 publications receiving 181920 citations.

Nonsteroidal Anti-Inflammatory Drugs and the Heart

Abstract: Aspirin has been on the market for 115 years. Beginning with the marketing of indomethacin for the treatment of rheumatoid arthritis in 1963, at least 20 other nonsteroidal anti-inflammatory drugs (NSAIDs) with aspirin-like actions have been developed over the past 50 years,1 culminating with the introduction of a new class of selective inhibitors of cyclooxygenase (COX)-2, the coxibs, approximately 15 years ago.2 The NSAIDs represent the single most crowded family of drugs sharing the same therapeutic activities and mechanism of action, perhaps reflecting the unmet therapeutic need in the area of pain management and the large interindividual variability in response to these agents. NSAIDs provide symptomatic relief of pain and inflammation associated with a variety of human disorders, including the rheumatic diseases. Their shared therapeutic actions (ie, analgesic, anti-inflammatory, and antipyretic) are usually accompanied by mechanism-based adverse effects that can, at least in part, be attenuated as a function of individual pharmacokinetic or pharmacodynamic properties.1 Nuances in the tolerability of different NSAIDs had been described in the precoxib era on the basis of clinical trials of a few hundred patients treated for up to a few months with soft end points. More recently, however, important differences in safety have been demonstrated in head-to-head randomized comparisons of individual coxibs and 1 or more traditional NSAIDs that involved tens of thousands of patients treated for up to a few years with hard end points. Even more significantly, the interpretation of the effects of NSAIDs has been greatly enhanced by the availability, for the first time, of large, placebo-controlled trials that aimed to assess the potential for chemoprevention of colorectal cancer by rofecoxib or celecoxib. As a result of these developments, the whole field of NSAIDs has been illuminated during the past 15 years. Although epidemiological studies had previously associated …

Postcodes as useful markers of social class: population based study in 26 000 British households.

Abstract: # Postcodes as useful markers of social class: population based study in 26 000 British households {#article-title-2} Markers of poverty or of low social class are associated with many diseases and potential causes of disease, but medical studies often fail to record sufficient information on socioeconomic status.1 Postcodes of individuals are, however, often available in Britain, and commercial software exists that estimates household income from the postcode alone. We assessed how informative postcode income estimates are, either about reported household income or about other characteristics related to social class in a large, population based survey of British residents. The family resources survey involves personal interviews with members of private households in England, Scotland, and Wales selected by stratified clustered probability sample.2 During 1995-6, 26 445 (70%) of 37 712 eligible households gave answers to questions on socioeconomic characteristics. Reported weekly household income was taken as the sum of all sources of pretaxation income (excluding housing benefit) reported by household members. During 1985 to 1993 members of 11 million households, or about half of all households in Britain, provided information to a marketing company about annual income and gave a complete address that included a full postcode—that is, 6 or 7 characters. This information was used to produce commercial software that estimates household incomes from postcodes. After adjustments for regional variation and for inflation in reported income levels, the pretaxation incomes of at least six households were used to calculate a weighted average income for that postcode. When there were fewer than six responses, the income information was combined with the data for respondents with neighbouring postcodes until a reliable estimate could be made. Parts of this database are updated annually. We compared household income estimates obtained by FIND (a …

Successful treatment without cranial radiotherapy of children receiving intensified chemotherapy for acute lymphoblastic leukaemia: results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI (ISRC TN 16757172).

Abstract: Concern about late adverse effects of cranial radiotherapy (XRT) has led to alternative approaches to eliminate leukaemia from the central nervous system (CNS) in childhood acute lymphoblastic leukaemia (ALL). The Medical Research Council UKALL XI trial recruited 2090 children with ALL between 1990 and 1997. Median follow-up is 7 years 9 months; event-free survival (EFS) and overall survival were 63.1% and 84.6%, respectively, at 5 years and 59.8% and 79.4% at 10 years. The isolated CNS relapse rate was 7.0% at 10 years. Patients were randomized for CNS-directed therapy within white blood cell (WBC) groups. For WBC /=50 x 10(9)/l, HDMTX with ITMTX was compared with XRT and a short course of ITMTX. CNS relapses were significantly fewer with XRT, but there was a non-significant increase in non-CNS relapses. EFS was not significantly different, being 55.2% (95% CI 47.8-62.6) at 10 years with XRT and 52.1% (95% CI 44.8-59.4) with HDMTX plus ITMTX.